Slavisa Tubin, Wolfgang Raunik
Institut für Strahlentherapie/Radioonkologie, Feschnigstraße 11, 9020 Klagenfurt am Wörthersee, Austria.
Case Rep Oncol Med. 2018 Jun 24;2018:6101759. doi: 10.1155/2018/6101759. eCollection 2018.
Currently, there are no specific recommendations regarding the management of the synchronous tumours due to the lack of either specific guidelines or individuals' clinical experiences relative to these clinical situations. In the presence of a locally advanced double primary tumour and with the lymph node metastases in addition, from the radiotherapeutical point of view, it must be challenging to manage this complicated situation that requires a more delicate treatment planning, due to higher doses prescribed to greater volumes concomitantly with the chemotherapy. A 68-year-old Caucasian male with a synchronous intermediate-risk prostate adenocarcinoma and locally advanced anal canal carcinoma underwent IMRT-SIB with concomitant chemotherapy at our institute. Two years after the treatment, the restaging CT and MRI scan showed no evidence of the disease and the patient reported no significant gastrointestinal or genitourinary toxicity. Our experience is unique, since it is the first report on using the IMRT-SIB technique simultaneously with chemotherapy in the management of the synchronous prostate and anal canal carcinomas. Therefore, we find it important to provide the current literature with the results from our experience which show good feasibility, efficacy, and tolerability of the definitive concomitant IMRT-SIB-chemotherapy for the synchronous anal canal cancer and prostate cancer.
目前，由于缺乏针对这些临床情况的具体指南或个人临床经验，对于同步性肿瘤的管理尚无具体建议。对于存在局部晚期双原发肿瘤且伴有淋巴结转移的情况，从放射治疗的角度来看，由于在进行化疗的同时需要对更大体积的组织给予更高剂量的照射，处理这种复杂情况且制定更精细的治疗计划必定具有挑战性。一名68岁的白种男性患有同步性中危前列腺腺癌和局部晚期肛管癌，在我们研究所接受了调强适形放疗-同步整合加量放疗（IMRT-SIB）并同步进行化疗。治疗两年后，复查CT和MRI扫描显示无疾病迹象，且患者报告无明显的胃肠道或泌尿生殖系统毒性。我们的经验是独特的，因为这是关于在同步性前列腺癌和肛管癌的管理中同时使用IMRT-SIB技术和化疗的首篇报道。因此，我们认为向当前文献提供我们的经验结果很重要，这些结果表明对于同步性肛管癌和前列腺癌，确定性同步IMRT-SIB-化疗具有良好的可行性、疗效和耐受性。
